高原人群红细胞渗透脆性研究  

A survey on osmotic fragility of erythrocytes in plateau population

作　　者：王爱萍 拉巴卓嘎[2] 李薇[3] 王轩智 谭若兰 普芝[2] 刘治娟[2] 秦绪珍[3] WANG Aiping;LABA Zhuoga;LI Wei;WANG Xuanzhi;TAN Ruolan;PU Zhi;LIU ZhiJuan;QIN Xuzhen(Department of Clinical Laboartory,Xian Savaid Obstetrics and Gynecology Hospital,Xian 710000,China;Department of Clinical Laboartory, Tibet Autonomous Region People's Hospital;Department of Clinical Laboartory, Peking Union Medical College Hospital)

机构地区：[1]西安存济妇产医院检验科,陕西西安710000 [2]西藏自治区人民医院检验科 [3]北京协和医院检验科

出　　处：《中国输血杂志》2024年第7期761-765,共5页Chinese Journal of Blood Transfusion

基　　金：西藏自治区自然科学基金组团式医学援藏项目[XZ2021ZR-ZY13(Z)];北京协和医院中央高水平医院临床科研专项(2022-PUMCH-A-059,2022-PUMCH-B-124)。

摘　　要：目的 研究高原环境下红细胞生理性增多、红细胞增多症及贫血患者红细胞渗透脆性变化。方法 纳入2020年10月西藏自治区人民医院门诊、住院患者及体检人群共174名,按照血红蛋白水平分为4组:红细胞增多症组(n=42)、红细胞生理性增多组(n=48)、贫血组(n=29)、健康对照组(n=55),并与同期北京协和医院检验科贫血患者及健康人群各67名作为平原对照组,采用经典的红细胞渗透脆性试验方法,比较各组样本的红细胞渗透脆性结果,包括开始溶血的NaCl溶液浓度(STH)和完全溶血的NaCl溶液浓度(CTH),采用SPSS软件对数据进行统计学分析。结果 高原人群中,健康人群汉族CTH与藏族差异有统计学意义(P<0.05);高原红细胞增多症组(0.52)STH高于高原健康对照组(0.48)(P<0.001);高原和平原比较,高原贫血组(0.36)、高原健康对照组(0.36)CTH中位数明显高于平原贫血组(0.28)、平原对照组(0.28)(P<0.001)。通过多因素Logistic回归分析显示,高原地区、女性红细胞增多症、贫血为STH升高的危险因素。结论 本研究显示高原地区人群、红细胞增多症患者红细胞渗透脆性增高。本研究为高原地区常见红细胞疾病及输血相关政策研究提供了依据。Objective To study the changes in erythrocyte osmotic fragility(EOF) in patients with hypercythemia,polycythemia and anemia under a high altitude environment.Methods A total of 174 outpatients,inpatients and people undergoing physical examination in Tibet Autonomous Region People′s Hospital in October 2020 were enrolled and divided into four groups according to hemoglobin levels:the polycythemia group(n=42),the physiologic increase group(n=48),the anemia group(n=29) and the healthy control group(n=55).They were compared with 67 anemia patients and 67 healthy people in the laboratory of Peking Union Medical College Hospital in the same period as the plain control group.The classic EOF test method was used to compare the results of each group′s EOF.The concentrations of NaCl solution for starting hemolysis(STH) and NaCl solution for complete hemolysis(CTH) were included,and the data were statistically analyzed by SPSS software.Results There was a significant difference in CTH between Zang and Han healthy people(P<0.05).STH in high altitude polycythemia group(0.52) was higher than that in high altitude healthy control group(0.48)(P<0.001).Compared with plain,the median CTH of plateau anemia group(0.36) and plateau health control group(0.36) was significantly higher than that of plain anemia group(0.28) and plain control group(0.28)(P<0.001).Multivariate logistic regression analysis showed that plateau region,female polycythemia and anemia were risk factors for STH elevation.Conclusion This study finds that the EOF increases in the plateau population and patients with polycythemia,which provides reference for studying red blood cell disorders and blood transfusion strategy in the plateau region.

关 键 词：红细胞渗透脆性 高原 生理性红细胞增多 

分 类 号：R331.141[医药卫生—人体生理学] R555.1[医药卫生—基础医学]